Grant: Operating Grant

This project will examine how the design of cities impacts healthcare costs. The links between the design of cities and physical activity (PA) levels has been the subject of several studies in recent years. We know that getting enough exercise helps people stay fit and maintain a healthy weight and we know that healthy weight and being active leads to less chronic disease. What we don't know is whether there is a link between the design of cities and how much healthcare costs. Canadian healthcare costs from chronic disease have been rising rapidly in recent years. Upstream policies that reduce health care costs by keeping people healthier are needed. This study will examine if adults in the Lower Mainland of British Columbia who live in places where neighborhood design makes it easy to walk and bike have lower healthcare costs than similar adults living in places that discourage walking and biking. The project will use databases that measure how easy it is to walk and bike in urban areas to evaluate the design of cities. It will use data from the BC Generations Project of over 15,000 participants to look at PA, diet, and weight; and information from Population Data BC to measure healthcare use and costs. First, we will look at the relationship between the built environment and PA. Next, we will study the link between built environment and activity-related diseases when taking physical activity into account. Third, we will consider the relationship between built environment and health care use costs, incorporating what we learn from the first two steps. Finally, using health care cost data over multiple years, linked to home address, we will see how health care costs change for people who move to a new address. The study will investigate the entire pathway: from design of cities, to PA, to health, and, finally, to healthcare costs. The results of this study will help leaders in public health, urban policy, and transportation planning to work towards healthy design.